Turkiye Klinikleri Journal of Medical Sciences

.: REVIEW
Demodicosis
Demodikoz
Ayça CORDAN YAZICIa, Güliz İKİZOĞLUa
aDepartment of Dermatology, Mersin University Faculty of Medicine,
Mersin, TURKEY
Turkiye Klinikleri J Med Sci. 2019;39(2):231-6
doi: 10.5336/medsci.2018-62140
Article Language: EN
Full Text
ABSTRACT
 Demodicosis is the term applied to cutaneous diseases caused by Demodex folliculorum and Demodex brevis. Demodex mites are acquired shortly after birth. They are saprophytic ectoparasites that are found primarily in areas rich in sebaceous glands, like face, scalp, neck. While human demodicosis is a skin disease sui generis, it can mimic many other inflammatory dermatoses. Therefore demodicosis are commonly underdiagnosed, and are masked behind other diagnoses such as papulopustular rosacea, erythemato telangiectasic rosacea, seborrheic dermatitis, perioral dermatitis, contact dermatitis, atopic dermatitis, phyma, seborrhea, etc. Human demodicosis is classified into a primary and secondary form by Chen and Plewig. Absence of pre-existing or concurrent inflammatory dermatosis (acne, rosacea or perioral dermatitis), abnormal increase in mite colonization in active lesions, and remission of the lesions following adequate treatment with topical or systemic acaricides/arachnicides, but not with antibiotics with antiinflammatory effects are diagnostic criteria of primary demodicosis. Secondary demodicosis is defined to skin lesions associated with an abnormal increase of Demodex mites in patients with other known skin or systemic diseases. Clinically, demodicosis has a wide range of variants and may manifest as folliculitis (Pityriasis folliculorum), papulopustular erythema (Rosacea-like demodicosis), blepharoconjunctivitis (demodectic blepharitis), and granulomatous rosacea-like demodicosis (Demodicosis gravis) The pathogenesis of human demodicosis remains largely obscure Here, we discuss the clinical manifestations, pathogenesis of demodicosis, and treatment strategies.

Keywords: Demodicosis; pathogenesis; clinical manifestations; treatment
ÖZET
 Demodikoz; Demodeks follikulorum ve Demodeks brevis tarafından oluşturulan deri hastalığını tanımlamak için kullanılan bir terimdir. Demodeksler saprofitik ektoparazitlerdir ve yüz, skalp, boyun gibi sebase bezlerden zengin alanlarda bulunurlar. Demodikoz, çok sayıda inflamatuar dermatozu taklit edebilir. Bu nedenle sıklıkla tanısı atlanır ve hastalar papülopüstüler rozase, eritemato telenjiyektazik rozase, seboreik dermatit, perioral dertmatit, kontakt dermatit, atopik dermatit, fima, sebore gibi tanılar alır. İnsan demodikozu Chen ve Plewig tarafından primer ve sekonder olarak sınıflandırılmıştır. Primer demodikoz tanısı; eşlik eden inflamatuar bir dermatozu (akne, rozase, perioral dermatit) olmayan, aktif lezyonlarda artmış parazit varlığı gösterilen ve tablonun antiinflamatuvar etkili antibiyotikler ile değil, topikal veya sistemik akarisid tedaviyle düzeldiği hastalar için kullanılır. Sekonder demodikoz ise bilinen bir deri veya sistemik hastalığı olan hastalarda demodeks yoğunluğunun artmasına denilir. Demodikozun çeşitli klinik varyantları vardır. Bunlar follikülit (pitriyazis follikulorum), papülopüstüler eritem (rozase benzeri demodikoz), blefarokonjuktivit (demodektik blefarit) ve granülomatöz rozase benzeri demodikozdur (demodikoz gravis). Hastalığın patogenezi tam olarak aydınlatılamamıştır. Bu derlemede demodikozun klinik özellikleri, patogenezi ve tedavisi anlatılmıştır.

Anahtar Kelimeler: Demodikoz; patojen; klinik belirtiler; tedavi
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